Begell House Inc.
Ethics in Biology, Engineering and Medicine: An International Journal
EBEM
2151-805X
5
1
2014
The Impact of Firearm Violence on the Healthcare System of the United States
1-12
10.1615/EthicsBiologyEngMed.2014012035
Michael
Lozovatsky
Department of Psychiatric Medicine, Seton Hall University School of Health and Medical Sciences, Trinitas Regional Medical Center, Elizabeth, NJ
Subrata
Saha
Affiliate Professor, Department of Restorative Dentistry; Affiliate Professor, Department of Oral and Maxillofacial Surgery, University of Washington, Seattle, WA, USA; Distinguished Adjunct Professor, Saveetha Institute of Medical and Technical Sciences, Chennai, India; President, Biomedical Research and Services Inc., Seattle, WA, 98125 USA
Firearm violence
firearm injury
health care costs
gun policy
gun safety
gun violence
The economic and human consequences of firearm-related violence extend beyond the boundaries of the immediate victims because this form of violence can impact every sector of a community, including the healthcare sector. Every year, these acts of accidental and aggravated assault contribute a disproportionate financial burden on the medical institutions that provide the lifesaving measures required to aid these victims. These expenditures, which total billions of dollars, exacerbate an already burdened healthcare system that projects annual expenditures equal to 17.6% of our national GDP. Our review of firearm-related injuries and the related financial cost suggests that the economic repercussions of firearm-related violence could be significantly reduced by enacting numerous policy initiatives that have been proposed within various state governments and their residing communities. As medical professionals, we have an ethical and moral obligation to bring this information to the public's attention and to encourage the development of policies that diminish the rise of firearm-related violence and its impact on this nation's healthcare system.
Robots, Androids, and Cyborgs in Warfare: Ethical and Philosophical Issues
13-23
10.1615/EthicsBiologyEngMed.2014011884
D. John
Doyle
Department of General Anesthesiology, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA
military robots
robot ethics
rules of engagement
war robots
Military robots are gradually entering the theater of war in many guises. As the capabilities of these robots move toward increased autonomous operation, a number of difficult ethical and legal issues must be considered, such as appropriate rules of engagement and even notions of robot ethics. In the distant future, as military "artificial beings" that draw on expected advances in cyborg and android technologies are developed, further issues of conscience, consciousness, personhood, and moral responsibility also arise.
Quality of Life and Community Reintegration Metrics in Spinal Cord Injury Patients
25-38
10.1615/EthicsBiologyEngMed.2014012056
loannis-Alexandros
Tzanos
Department of Physical and Rehabilitation Medicine, EIAA Hospital, Athens, Greece
Andreas F.
Mavrogenis
First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, Athens, Greece
Evanthia
Mitsiokapa
P.N. Soukakos Orthopaedic Research and Education Center, Sylvia Ioannou Biomechanics and Gait Analysis Laboratory, Attikon University Hospital, First Department of Orthopaedic Surgery, Medical School, National and Kapodistrian University of Athens, Athens, Greece
Konstantinos
Vlasis
Department of Anatomy, School of Medicine, National and Kapodistrian University of Athens, Greece
Konstantinos
Soultanis
First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Orthopaedic Research and Education Center (OREC) Panayotis N. Soucacos, Athens, Greece
George
Tzanos
Department of Physical and Rehabilitation Medicine, Thriasion Hospital, Elefsis, Greece
Panayiotis J.
Papagelopoulos
First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, Athens, Greece
spinal cord injury
quality of life
community reintegration
During the past few decades, quality of life (QOL) and community reintegration have gained recognition as important indicators of the success of variable rehabilitation programs in patients with disabilities, especially those with spinal cord injury (SCI). SCI patients face tremendous challenges in adapting to the physical aspect of injury and to the changes it may bring with regard to living situation, lifestyle, relationships, and adjustment. Current advances in medical care have enabled patients with SCI to survive the initial injury and to prolong their life expectancy post-SCI. In these patients, rehabilitation focuses on the consequences of the injury, with the goal of enabling the patient to be an active and productive member of society, well integrated into the community, and highly satisfied with his or her QOL. In this setting, the need for outcome measures assessing health and QOL following rehabilitation has become increasingly important. Simple outcomes assessing function were insufficient in measuring rehabilitation after SCI, and in capturing the adaptation of perceptions and values in these patients. Additionally, it has been suggested that high levels of QOL reflect positive rehabilitation outcomes, and many agree that QOL should be measured in combination with traditional outcomes assessing functional rehabilitation. In this article, we provide a comprehensive overview of the literature regarding the QOL and community reintegration, the description and identification of their outcome measures, as well as the personal and environmental variants and barriers that affect an individual with SCI in his or her postrehabilitation life. An understanding of these parameters will help rehabilitation doctors to design a successful rehabilitation strategy for these patients.
Allergic to Technology: Ethics and the "Electrically Hypersensitive" Individual
39-50
10.1615/EthicsBiologyEngMed.2014012087
Kenneth R.
Foster
Department of Biomedical Engineering, University of Pennsylvania, Philadelphia, PA 19104, USA
G. James
Rubin
King's College London, Department of Psychological Medicine, Weston Education Centre, London, United Kingdom
Idiopathic Environmental Intolerance Attributed to Electromagnetic Fields
electromagnetic hypersensitivity
nocebo effect
placebo effect
electromagnetic fields
nonspecific response
accommodation
truthfulness of caregivers
Idiopathic Environmental Intolerance Attributed to Electromagnetic Fields (IEI-EMF) is a medically unexplained condition characterized by a wide variety of nonspecific symptoms that an individual attributes to exposure to electromagnetic fields (EMF) in the environment produced by commonplace technologies. This article briefly reviews the scientific basis of the condition and some of the ethical issues raised by it. Taken as a whole, provocation studies have shown that people with IEI-EMF are unable to detect when they are being exposed to EMF with a probability greater than chance; IEI-EMF is a self-diagnosed condition by affected individuals. Ethical issues raised by IEI-EMF are generally similar to those raised by other forms of medically unexplained illness; however, they have significant social implications in view of the reliance of modern society on the electromagnetic spectrum. Implications for social policy include how to respond to the desires of affected individuals to be protected against the effects of low-level EMF in the environment, and possible harms to the individuals from well-meaning but inappropriate treatment. High-quality research and registration of clinical trials to improve treatment of the condition are needed.
Imposing Harm to Preserve Life: The Ethics of Physician Involvement in Developing Nonlethal Technology
51-69
10.1615/EthicsBiologyEngMed.2015013052
Benjamin A.
Drew
Division of Medical Ethics, Harvard Medical School, MS4; Castle Society, 25 Shattuck Street, Boston, MA 02115
nonlethal weapons
asymmetric warfare
research ethics
harm reduction
utilitarianism
double effect
mixed agency
A new generation of nonlethal weapons (NLWs) has emerged that may alter the future of warfare by reducing casualties and preserving life. Since NLWs are increasingly reliant upon biomedical advances in neuroscience, physiology, and pharmacology, their safe and effective deployment will depend upon medical expertise, insight, and experience. Given that medicine is devoted to the goal of saving lives, physicians and medical scientists are confronted by an ethical dilemma as to whether they are permitted to support NLWs research. Considering the stakes involved, it is unrealistic to examine the ethics of medical involvement exclusively in terms of a pledge never to do harm. Assuming NLWs fulfill their intended purpose to reduce injury and prevent mortality on the battlefield, this author argues that physicians may be permitted to contribute to the development of nonlethal technology based upon theories of harm reduction, utility, double effect, and mixed agency.
Biomedical Ethics and Legal Perspectives
71-77
10.1615/EthicsBiologyEngMed.2015013123
Bijayesh
Haldar
Centre of Biological Engineering, Shobhit University, Gangoh, Saharanpur, India
Bishnanand
Dubey
School of Law and Constitutional Studies, Shobhit University, Gangoh, Saharanpur, India
Durg Vijay
Rai
Centre of Biological Engineering, Shobhit University, Gangoh, Saharanpur, India
human rights
law
clinical trials
mechanism
guidelines
Biomedical sciences have expanded considerably in the last few decades and have received special attention for their contribution to improvement in the quality of human life. In recent years, the biomedical sciences have emerged as a growing field of innovative scientific research. Therefore, it is very important to have social enforcement of the importance of the contributions of biomedical sciences in morality, ethics, and law. It has been universally accepted that without human clinical trials, new vaccines or drugs cannot be launched in the market. However, there are various reports and guidelines available by different global bodies to address law, ethics, and morality in human clinical trials, such as the World Medical Association Guidelines, the Nuremberg Code, and the United Nations Declaration on Bioethics and Human Rights. Even with these rules and guidelines, a legitimate enforcement mechanism is required to give equal priority to ethics and morality with law in a framework. Ethics and morality are used in part to create laws, but the priority of ethics and morality is sometimes ignored. An attempt has been made to initiate universal rules/guidelines that could bridge the gap between law, ethics, and morality to ensure equality, freedom, justice, and dignity for individuals and to regulate the law in biomedical ethics. India recently began bold efforts to control the menace of illegal biomedical trials by observing the Supreme Court guidelines.
Pervasive Technologies: Principles to Consider
79-93
10.1615/EthicsBiologyEngMed.2015013104
Christine
Perakslis
College of Management, Johnson & Wales University, Providence, Rhode Island
Jeremy
Pitt
Department of Electrical and Electronic Engineering, Imperial College, London, United Kingdom
Katina
Michael
School of Information Systems and Technology, University of Wollongong, Wollongong, New South Wales, Australia
M.G.
Michael
School of Information Systems and Technology, University of Wollongong, Wollongong, New South Wales, Australia
bearables
calm technology
crowd sensing
IoT
participatory sensing
pervasive technology
wearables
self-quantification
quantification of self
H2M
M2M
G2V
H2H
The purpose of this article was to explore the ethics perspective when contemplating such pervasive technologies as those utilizing biological data and thereby likely to create susceptibilities for users. The authors considered the intensification of opt-in, self-monitoring data collection through such technologies as wearables and bearables, as well as the Internet of Things (IoT), which is burgeoning through the increase of devices, systems, and services that continue to be developed and linked to the infrastructure aggregating vast data. With researchers estimating up to 30 billion devices wirelessly connected to the IoT by 2020, time is of the essence to address ethical considerations. A review of the literature included an overview of the state of such technologies as well as salient issues. The authors then considered the trajectory of such technologies against the backdrop of the principles incorporated in the European Union and international treaties as well as the laws of EU member states, which are as follows: the precautionary principle, the purpose specification principle, the data minimization principle, the proportionality principle, and the principle of integrity and inviolability of the body, and dignity. The authors utilized a philosophical research approach with intellectual analyses to support value judgments.